title: Probability elicitation to inform early health economic evaluations of new medical technologies: a case study in heart failure disease management.
abstract: OBJECTIVE
  Early estimates of the commercial headroom available to a new medical device can assist producers of health technology in making appropriate product investment decisions. The purpose of this study was to illustrate how this quantity can be captured probabilistically by combining probability elicitation with early health economic modeling. The technology considered was a novel point-of-care testing device in heart failure disease management.
  
  
  METHODS
  First, we developed a continuous-time Markov model to represent the patients' disease progression under the current care setting. Next, we identified the model parameters that are likely to change after the introduction of the new device and interviewed three cardiologists to capture the probability distributions of these parameters. Finally, we obtained the probability distribution of the commercial headroom available per measurement by propagating the uncertainty in the model inputs to uncertainty in modeled outcomes.
  
  
  RESULTS
  For a willingness-to-pay value of €10,000 per life-year, the median headroom available per measurement was €1.64 (interquartile range €0.05-€3.16) when the measurement frequency was assumed to be daily. In the subsequently conducted sensitivity analysis, this median value increased to a maximum of €57.70 for different combinations of the willingness-to-pay threshold and the measurement frequency.
  
  
  CONCLUSIONS
  Probability elicitation can successfully be combined with early health economic modeling to obtain the probability distribution of the headroom available to a new medical technology. Subsequently feeding this distribution into a product investment evaluation method enables stakeholders to make more informed decisions regarding to which markets a currently available product prototype should be targeted.
authors.affiliation: Department of Epidemiology, University of Groningen, University Medical Center of Groningen, Groningen, The Netherlands. q.cao@umcg.nl
authors.forename: Qi
authors.initials: Q
authors.lastname: Cao
authors.forename: Douwe
authors.initials: D
authors.lastname: Postmus
authors.forename: Hans L
authors.initials: HL
authors.lastname: Hillege
authors.forename: Erik
authors.initials: E
authors.lastname: Buskens
mesh_terms: D020811:Biomedical Technology / Q000191:economics* / Q000379:methods; D003657:Decision Making; D018450:Disease Progression; D004867:Equipment Design; D004864:Equipment and Supplies / Q000191:economics; D005382:Financing, Personal / Q000191:economics*; D005500:Follow-Up Studies; D006331:Heart Diseases / Q000191:economics / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D008390:Markov Chains; D018803:Models, Economic; D017063:Outcome Assessment, Health Care; D019095:Point-of-Care Systems / Q000191:economics; D011336:Probability